PHARMACOLOGICAL SHEET

Patient Name: BALDESTOY, Benedict

Age: 19 years old

Sex: Male
Diagnosis: Hepatoma; CAP-MR
DRUG NAME GENERAL ACTION SPECIFIC ACTION INDICATION CONTRAINDICATIO SIDE/ADVERSE NURSING
N EFFECTS RESPONSIBILITIES
1. Spironolactone ELECTROLYTIC Steroidal compound Clinical conditions Anuria, acute renal CNS: Lethargy, Check blood pressure
and specific associated with insufficiency; mental confusion, before initiation of
25mg 1 tab BID AND WATER therapy and at regular
BALANCE AGENT; pharmacologic augmented progressing fatigue (with rapid
intervals throughout
antagonist of aldosterone impairment of weight loss), therapy.
POTASSIUM- headache,
aldosterone. production, as in kidney function, Lab tests: Monitor serum
SPARING DIURETIC drowsiness, ataxia. electrolytes (sodium and
Presumably acts by essential hyperkalemia
competing with hypertension, Endocrine: potassium) especially
Gynecomastia (both during early therapy;
aldosterone for refractory edema monitor digoxin level
cellular receptor due to CHF, hepatic sexes), inability to
when used concurrently.
achieve or maintain
sites in distal renal cirrhosis, nephrotic Assess for signs of fluid
erection, androgenic and electrolyte
tubule. Promotes syndrome, and
effects (hirsutism, imbalance, and signs of
sodium and chloride idiopathic edema.
irregular menses, digoxin toxicity.
excretion without May be used to deepening of voice); Monitor daily I&O and
concomitant loss of potentiate actions parathyroid changes, check for edema. Report
potassium. Diuretic of other diuretics lack of diuretic response
decreased glucose or development of
effect reportedly not and tolerance, SLE. GI: edema; both may
associated with antihypertensive Abdominal cramps, indicate tolerance to
hyperuricemia or agents or for its nausea, vomiting, drug.
hyperglycemia. potassium-sparing anorexia, diarrhea. Weigh patient under
Activity depends on effect. Also used for standard conditions
Skin: Maculopapular
before therapy begins
presence of treatment of (and as or erythematous and daily throughout
endogenous or presumptive test rash, urticaria. therapy. Weight is a
exogenous for) primary Metabolic: Fluid and useful index of need for
aldosterone. aldosteronism. electrolyte imbalance dosage adjustment. For
(particularly patients with ascites,
physician may want
hyperkalemia and
measurements of
hyponatremia); abdominal girth.
elevated BUN, mild Observe for and report
acidosis, immediately the onset of
hyperuricemia, gout. mental changes,
Body as a Whole: lethargy, or stupor in
patients with liver
Drug fever.
disease.
Hematologic: Adverse reactions are
Agranulocytosis. CV: generally reversible with
Hypertension (post- discontinuation of drug.
sympathectomy
patient).
DRUG NAME GENERAL ACTION SPECIFIC ACTION INDICATION CONTRAINDICATIO SIDE/ADVERSE NURSING
N EFFECTS RESPONSIBILITIES
Azithromycin ANTIINFECTIVE; A macrolide Pneumonia, lower Hypersensitivity to CNS: Headache, Monitor for and
500mg/tab 1 tab MACROLIDE antibiotic that respiratory tract azithromycin, dizziness. GI: report loose stools
OD ANTIBIOTIC reversibly binds to infections, erythromycin, or Nausea, vomiting, or diarrhea, since
the 50S ribosomal pharyngitis/tonsilli any of the diarrhea, pseudomembrano
subunit of tis, gonorrhea, macrolide abdominal pain; us colitis must be
susceptible nongonococcal antibiotics. hepatotoxicity, ruled out.
organisms and urethritis, skin and mild elevations in Monitor PT and
consequently skin structure liver function INR closely with
inhibits protein infections due to tests. concurrent
synthesis. susceptible warfarin use.
organisms, otitis Report onset of
media, loose stools or
Mycobacterium diarrhea.
avium
intracellulare
complex
infections, acute
bacterial sinusitis.
Acetylcysteine SKIN AND Acetylcysteine Adjuvant therapy in Hypersensitivity to CNS: Dizziness, Monitor for S&S of
600mg 1 tab in MUCOUS lowers viscosity patients with acetylcysteine; drowsiness. GI: aspiration of excess
1/2 glass of MEMBRANE and facilitates the abnormal, viscid, or patients at risk of Nausea, vomiting, secretions, and for
AGENT; removal of inspissated mucous gastric hemorrhage. stomatitis, bronchospasm
secretions in acute hepatotoxicity (unpredictable);
MUCOLYTIC; secretions.
and chronic (urticaria). withhold drug and
ANTIDOTE bronchopulmonary Respiratory: notify physician
diseases, and in Bronchospasm, immediately if
pulmonary rhinorrhea, burning either occurs.
complications of sensation in upper Lab tests: Monitor
cystic fibrosis and respiratory ABGs, pulmonary
surgery, passages, epistaxis. functions and pulse
tracheostomy, and oximetry as
atelectasis. Also indicated.
used in diagnostic Have suction
bronchial studies apparatus
and as an antidote immediately
for acute available. Increased
acetaminophen volume of
poisoning. respiratory tract
fluid may be
liberated; suction or
 endotracheal
aspiration may be
necessary to
establish and
maintain an open
airway. Older adults
and debilitated
patients are
particularly at risk.
Nausea and
vomiting may occur,
particularly when
face mask is used,
due to unpleasant
odor of drug and
excess volume of
liquefied bronchial
secretions.
Lactulose 30ml OD GASTROINTESTINA Acidifies colon Prevention and Low galactose diet GI: Flatulence, Promote fluid intake
at HS L AGENT; contents, which treatment of portal- borborygmi, (15002000 mL/d)
retards diffusion of systemic Caution use: belching, abdominal during drug therapy
HYPEROSMOTIC nonionic ammonia
LAXATIVE encephalopathy Diabetes mellitus; cramps, pain, and for constipation;
(NH3) from colon to
(PSE), including concomitant use distention (initial older adults often
blood while promoting
its migration from stages of hepatic with electrocautery dose); diarrhea self-limit liquids.
blood to colon. In the precoma and coma, procedures (excessive dose); Lactulose-induced
acidic colon, NH3 is and by prescription (proctoscopy, nausea, vomiting, osmotic changes in
converted to for relief of chronic colonoscopy); older colon accumulation the bowel support
nonabsorbable constipation. adult and of hydrogen gas; intestinal water loss
ammonium ions (NH4) debilitated patients; hypernatremia. and potential
and is then expelled in pediatric use. hypernatremia.
feces by laxative Discuss strategy
action. Decreased with physician.
blood ammonia in a
Notify physician if
patient with hepatic
encephalopathy is
diarrhea (i.e., more
marked by improved than 2 or 3 soft
EEG patterns and stools/d) persists
mental state (clearing more than 2448 h.
of confusion, apathy, Diarrhea is a sign of
and irritation). overdosage. Dose
Osmotic effect of adjustment may be
organic acids causes indicated.
laxative action, which
moves water from
plasma to intestines,
softens stools, and
stimulates peristalsis
by pressure from
water content of stool.